St. Joe vows mission won't change

Advocates worry about access to care for poor, uninsured.

Advocates worry about access to care for poor, uninsured.

December 13, 2009|JEFF PARROTT Tribune Staff Writer

MISHAWAKA -- Saint Joseph Regional Medical Center's gleaming new $355 million hospital on Mishawaka's far-northeastern fringe differs greatly from its predecessor. It's bigger. It's more modern. It's more efficient. Built near the predominantly white and affluent areas of Granger and northwestern Elkhart County, there's another big difference. It's no longer in a diverse and densely populated city. Since its founding on Madison Street in South Bend in 1882 by the Sisters of the Holy Cross, the Catholic hospital has prided itself on its mission of caring for the poor and underserved. Hospital spokesman Mike Stack said that remains true today. "The hospital is not abandoning its mission," Stack said. "That's something that is rock-solid and will be forever." Last year, South Bend's two hospitals, Saint Joseph and Memorial Hospital, reported similar charity care-to-gross revenue ratios, according to annual reports filed with the Indiana State Department of Health. Saint Joseph's two hospitals -- the Mishawaka and South Bend facilities -- combined delivered about $35.6 million in unreimbursed care, about 5.6 percent of their roughly $623 million in gross revenue. Memorial reported providing about $48 million in unreimbursed care, or about 5.9 percent of its approximately $794 million in gross revenue. When they first announced plans in 2002 to build anew at the Mishawaka Douglas Road site, Saint Joseph officials said their own analysis showed that the hospital would have the same "payer mix" -- the proportion of various insurance plans used by its patients -- after the move as it did before. In other words, the proportion of paying to nonpaying customers won't change. But those who advocate for quality health care for the poor and minorities say they doubt that will hold true. Karl Nichols, executive director of the St. Joseph County Minority Health Coalition, said many inner-city residents will lack the transportation to Douglas Road, about four miles northeast of the current site. As a result, he thinks they'll go to Memorial Hospital, located near downtown on Michigan Street, for urgent care. "They're going to get hammered," Nichols said of Memorial's emergency department. "It's a well-known fact that people without insurance go to the emergency room." Nichols said he is worried about longer waits for care at Memorial's ER. Now that the Saint Joseph move is imminent, he plans to focus on working on more preventive care programs with Memorial, so that more inner-city residents can avoid needing emergency care. Tough to predict Stack said it's too soon to know whether the new hospital will see fewer uninsured patients in the ER. "No one has any way of answering that," Stack said. "The ER is open for anybody, and whoever comes in the door will be treated. Where they're going to come from, we can't predict that." Stack noted that Saint Joseph will continue to operate its primary care clinics: The Sister Maura Brannick Health Center at Chapin Street and Western Avenue; the Healthy Family Center, 420 W. Fourth St. in Mishawaka; and Bendix Family Physicians, a joint effort with Memorial opened in June near Bendix Drive and Lincoln Way West on South Bend's west side. Saint Joseph also will continue to operate its Mobile Medical Unit, a sort of clinic on wheels that reaches out to lower-income and underserved areas, he said. But those clinics are not open at night, Nichols said. The Maura Brannick Center treats patients who lack insurance, but by appointment only. "Access is a huge deal," Nichols said. "I know there's going to be a gap in service, and we were never consulted about those gaps." Ann Puzzello, a South Bend Common Council member whose district encompasses the soon-to-be-closed South Bend hospital site, called the move a "shame." "It's my opinion that there will be times of the day when South Bend people need a hospital in an emergency and they're going to have trouble getting there in a timely manner," Puzzello said. "We'll find out real quickly with Christmas time because of the traffic out on Grape Road." Puzzello said she thinks it is "very likely" that Memorial's emergency department will start seeing more patients. "I think what we'll need is a closer inner-city urgent care facility," she said. "If things get difficult at Memorial as the only emergency care center in the city, I think that's something we will have to look into." Memorial is braced Diane Stover, vice president of marketing and innovation strategy at Memorial, said her hospital's emergency department expects more volume because of Saint Joseph's move, but she is confident Memorial can handle it. Five years ago Memorial upgraded its emergency department, adding staff, equipment and space, to become the area's only Level II trauma center. Those efforts will leave Memorial well-positioned for any patient shift from the former Saint Joseph site, Stover said. "We are ready for this," Stover said. "This is not anything unexpected." With that said, Stover said she isn't convinced that the urban poor and uninsured won't find their way to the new Saint Joseph hospital. In announcing the Douglas Road site in 2002, Saint Joseph officials said they had surveyed mothers of children covered by Medicaid and found they go to University Park Mall, located near the new site, "more often than average." "If people can get to that area for one reason, why can't they get there for another reason?" Stover said. "It makes sense to me." Stack noted that Transpo has added a new bus route to serve the new hospital.Staff writer Jeff Parrott: jparrott@sbtinfo.com (574) 235-6320